Independent Commission on Mental Health and Policing

The report of the Commission on Mental Health and Policing, chaired by Lord Victor Adebowale CBE, was published today. There are significant recommendations for the Metropolitan Police Service (MPS), but there are issues raised in the report that are of direct relevance to London boroughs, not least questions on multi-agency working and strategic governance.

Overview

An Independent Commission on Mental Health and Policing was set up in September 2012 at the request of the Metropolitan Police Commissioner.

The Commission’s brief was to review the work of the Metropolitan Police Service (MPS) with regard to people who have died or been seriously injured following police contact or in police custody and to make recommendations to inform MPS conduct, response and actions where mental health is, or is perceived to be, a key issue. The Commission published its report today.

The Commission reviewed 55 cases involving people with mental health issues over the past five years. Five cases were deaths in police custody and 45 deaths were either prior to or following contact with the police. The other five cases resulted in serious injury.

The report states that Commission viewed mental health as a “core part of the business of policing”. This is a perspective that is likely to be welcomed by boroughs, given the experience of local authorities in promoting community safety and in particular talking anti-social behaviour, where mental health issues are a significant factor.

Analysis

The report states that mental ill health is more common in London than in other parts of the country with 18 per cent of people living in the capital having a common mental health problem, compared to 16 per cent nationally. It is estimated to cost the capital nearly £2.5 billion in health and social care cost as well as £5.5 billion in lost working days.

The area of focus for the Commission that is most relevant for local authorities was inter-agency working. Examples cited in the report focused on gaps between the MPS and NHS, London Ambulance Service (LAS), and hospitals. Examples were also provided where existing systems such as multi agency risk assessment (MARAC) were not used.

The report cites Mental Health Partnership Boards, which include local authority officers, as being a good foundation for partnership work.

The Commission identified some examples of good practice in boroughs including:

**Sutton Council** and South West London and St George’s Mental Health NHS Trust convening a regular risk forum with local police and other relevant agencies to discuss people of concern who may be vulnerable or may pose a risk to others. This is cited as a good practice example as it covers people who do not fit the criteria for other forums such as multi-agency safeguarding hubs for children (MASH) or multi-agency public protection agreements (MAPPA).

And

London Boroughs of **Wandsworth and Merton**, where there are structures for multi-agency discussion about people who may be at risk of self-harm or neglect for a variety of reasons, including mental illness, where the police maybe a key attendee.

The key recommendations in the report that relate to local authorities are as follows:

**Recommendation 15 (to be implemented immediately)** Establish a data management approach for vulnerable adults which includes both a mechanism to record and a mechanism to refer incidents involving adults in mental distress.

**Recommendation 22 (to be established over the next six months)** It is the Commission’s view that there is a compelling mandate for a closer and more effective relationship between the MPS and the NHS. The report goes on to recommend that the existing London Mental Health Partnership Board should have formal recognition and mandate specifically agreed with NHS England, the MPS, the Association of Directors of Adult Social Services (ADASS) and Mayor’s Office for Police And Crime (MOPAC) as part of the Mayor’s accountability for health. This would constitute a central oversight mechanism for improving mental health and policing in London.

**Recommendation 25 (to be established over the next six months)** The MPS should:

- establish joint protocols to identify a basis for effectively sharing information with partner agencies for adults at risk with mental health problems;
- work with the Mental Health Partnership Board to establish a multiagency mechanism for risk assessing, case managing and information sharing in relation to people with mental health problems who are perceived to be at high level of vulnerability;
- ensure senior and authoritative representation on the Local Authority-led multiagency Adult Safeguarding Partnership Boards.

**Recommendation 26 (to be implemented immediately)** The MPS and its NHS partners should immediately implement the Bradley Report recommendation so that all police custody suites should have access to liaison and diversion services.

**Recommendation 27 (to be established over the next six months)** The MPS should urgently work with local authorities and mental health trusts to ensure existing protocols and procedures for information sharing; risk assessment and management are adhered to and monitored. This should include taking account of local authority led strategic safeguarding structures to promote public safety and wellbeing. Recommendation 27 (to be established over the next six months) The MPS should agree protocols for joint working on service provision with reference to Approved Mental Health Professionals, emergency duty teams and wider social care services.

Commentary The Commission has concluded that the MPS urgently needs to improve its response to mental health in order reduce the likelihood of deaths or serious injury, as in the 55 cases reviewed in the study, occurring in the future.

While the findings and recommendations are by necessity focused on the MPS, there are significant recommendations around multi-agency working that boroughs will want to consider as they shape next steps to improve interagency working and partnership governance.

London Councils is currently working closely with borough Heads of Community Safety to establish a range of joined-up mental health and social care intervention that prevent the escalation of anti-social behaviour where there is a mental health dimension.

Author: Rangan Momen, Principal Policy and Project Officer (T: 020 7934 9816) Click here to send a comment or query to the author

Links: Independent Commission on Mental Health and Policing report

This member briefing has been circulated to: Portfolio holders and those members who requested policy briefings in the following categories: Crime and Public Protection, Health and Adult Services